# NORTHEAST YOUTH & FAMILY SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NORTHEAST YOUTH & FAMILY SERVICES
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1073098810
- **Legal business name:** NORTHEAST YOUTH & FAMILY SERVICES
- **Authorized official:** MS. LISA M PAQUET BA (CLINIC OPERATIONS MANAGER)
- **Authorized official phone:** (651) 379-3443

## Contact information

- **Practice address:** 1280 N BIRCH LAKE BLVD, WHITE BEAR LAKE, MN 55110-6708
- **Practice address phone:** (651) 429-8544
- **Practice address fax:** (651) 407-5301
- **Mailing address:** 3490 LEXINGTON AVE N STE 205, SHOREVIEW, MN 55126-8044
- **Mailing address phone:** (651) 486-3808
- **Mailing address fax:** (651) 486-3858

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/27/2018
- **Last updated:** 09/27/2018